The overall goal of this project is to provide information that will promote the linkage of identification of hearing loss in young infants with timely and appropriate interventions. Forty-two states are currently involved in universal newborn screening efforts, yet less than half of early-identified infants are reported to receive intervention by 6 months of age. Current system barriers include lack of information among health care providers, lack of experience with infants among audiologists and early interventionists, and lack of information available to parents. This creates a critical need to communicate with medical professionals, audiologists, early interventionists and parents about follow up to newborn hearing screening in order to optimize the benefits of early detection. This project represents an expansion of our previous successful efforts (R25 DC04599) related to newborn hearing screening, diagnosis and intervention. The first aim of this project is to increase the knowledge and change attitudes of nurses engaged in pediatric settings regarding newborn screening, diagnosis and parent support. Following identification of needs through focus group and survey work, health communication programs will be developed and tailored to specific nursing practice settings (e.g., newborn nursery vs. family practice office vs. obstetrics and gynecology). A multifaceted program of health communication will be developed to include multimedia web based resources, online CME courses, in service curricula, parent education resources and other materials identified through needs assessments. Selected materials will be evaluated empirically. The results should influence a professional group with key contacts in the medical community with parents. The second aim is to increase the technical skills of audiologists related to infant hearing aid fittings and early interventionists related to family centered practice principles. Multimedia resources will be created in website and DVD formats. The results should promote appropriate fitting of amplification in young infants and improve strategies for involving families in the intervention process. The final aim is to expand efforts to inform parents and professional audiences about recent research and state of the art practices related to infant hearing loss. This effort includes recreation of www.babyhearing.org in Spanish and further expansion of the content in response to needs identification of families. Information also will be re-purposed and expanded to meet the needs of the target professional audiences. The results of this effort should promote parent self-advocacy and independence in decision making. [unreadable] [unreadable]